Bridges

What Are Bridges And Why Are They Used?

Bridges are used to replace one or more missing teeth but are non-removable and have to be attached to adjacent teeth on both sides of the missing tooth (teeth). Sometimes bridges are recommended because the adjacent teeth are damaged or crooked and can be made to look or bite properly when the bridge is completed. The surfaces of the adjacent, supporting teeth are carefully shaped in preparation for making the bridge. Bridges are a reasonable tooth replacement restoring moderate strength.  They should last many years.

Bridges

Did you know:

  • Unreplaced missing back teeth often result in many other teeth including the front teeth becoming crooked, worn and a problem overbite
  • Missing front teeth often result in speech impediments

Frequently Asked Questions

The first step is to design and plan the bridge, similar to a construction blueprint, to optimize its size, shape, your bite and access for cleaning. During the second step, your teeth are carefully and meticulously shaped in preparation to support the eventual finished bridge. During this same shaping and measuring appointment, a temporary acrylic (plastic) bridge is made which will keep the shaped teeth comfortable, protect them and allow you to eat, speak and have a normal appearance between appointments.  Also during this second step, measurements or molds are made from which a precisely fitted and natural appearing bridge can be custom made in the dental laboratory.  The laboratory process of making your bridge occurs between appointments and is completed by specially trained laboratory technicians. The final steps involve completion of any adjustments to your bridge and its attachment, after which your bridge is not removable.

A bridge is most commonly made using an inner framework of alloyed gold (usually silver color) for strength and an outer layer of ceramic which is tooth colored.  Bridges can be made entirely of gold in which case they are usually yellow in color.  A tooth which supports a bridge may first require a filling to eliminate defects created by previous decay, fractures or old deteriorated fillings.  When a tooth is severely broken down, root canal treatment may be required in order to allow the use of a post inside the root to rigidly hold a large foundation filling, which would then provide a solid foundation and prevent the bridge from coming loose.  Root canal treatment may also be required before or after a bridge is placed if the nerve in the center of the tooth becomes infected or abscessed.

High quality, natural looking bridges need to be more than just ‘white’, they must approximate the complex color scheme of your other teeth or they will stick out like a ‘sore thumb’. Color is approximately matched using standardized color tabs which are selected with your approval and is included in basic bridge fees. If your bridge is prominently visible, some degree of additional customization will usually be required to more closely match your other teeth. This customization process can proceed until the best possible match is obtained subject to the limitations of man-made materials and fees based on the length of time required for customization. When skillful clinical treatment is combined with artful laboratory technical work it is often difficult to detect the difference between a well made bridge and your natural teeth. Natural teeth will tend to slowly darken with age. Teeth replaced and restored with a bridge will remain the same color.

Shape is extremely critical and is one of the most frequently overlooked aspects of many bridges. This has resulted in an otherwise attractive smile being ruined by bridges not matching the remaining teeth and appearing as if they stick out. Proper shape is also required to prevent food jamming between teeth and to permit easy and thorough cleaning to avoid bad breath.

Red, blue or swollen gums and gum recession are ugly and can be caused by improperly made bridges. The gum around the bridge made with gentle techniques should be pink, firm, not bleed during cleaning and not suffer significant recession.

A well made bridge should have a perfect bite and feel completely even with the other teeth on the very first day and does not require time to settle in.  An uneven bite will either be uncomfortable or allow your teeth to shift and become crooked.

The shape of the teeth under a bridge is extremely critical.  If properly designed and shaped, bridges should not fall off and should look like they have an excellent alignment and appearance.  Expert treatment during the shaping of the teeth when the bridge is first made can essentially eliminate needless future costs of re-attaching or remaking a bridge that won’t stay on.  Mistakes in shaping the teeth for a bridge can cause harm to the gum or the tooth nerve resulting in the need for additional expensive treatment at best and at worst, can not be undone or reversed resulting in a permanent defect.

A bridge should feel comfortable, look natural and maintain or restore your ability to eat and speak.  Our patients routinely can’t feel much difference between a real tooth and a bridge.

Do not expect your general dentist to obtain the results routinely obtainable in our prosthodontic specialty office.  General dentists try to stay on top of all the general routine treatments patients need but can’t be expected to be capable of providing specialized treatment.  There are some capable dental specialists in Mexico and elsewhere but always beware of ‘discount dentistry’.  An attempt to obtain specialty treatment from those without the appropriate training and experience is likely to create problems and regret.

Most bridges fail because of tooth decay under the edge of the bridge or gum disease, both of which are frequently caused by average or poor fitting bridges and inadequate cleaning. An extremely well fitting bridge is less likely to allow decay to get under the bridge destroying the tooth underneath it. A bridge that can be properly cleaned will last much longer, increasing the likelihood that you will keep your teeth a lifetime and reduce future dental care and costs.

Cleaning teeth with bridges is not too different from cleaning natural teeth. You must thoroughly brush your teeth and clean between the teeth and under the replacement teeth using the appropriate cleaning aid every day. You will be shown and coached on the techniques necessary to care for your bridge and supporting teeth. Bridges and their supporting teeth must be regularly cleaned and checked by your dentist to ensure the gum and bone does not break down or the supporting teeth do not get cavities or decay.  An extremely well fitting bridge, that can be properly cleaned will last much longer and increase the likelihood you will keep your teeth a lifetime at less cost. A bridge with average or poor fit can’t be cleaned properly and is not likely to last long.

Bridges should be strong and not easily break. Unfortunately, elsewhere, in an effort to decrease costs, bridges can be made cheaply and from weaker materials with very unfortunate results.

By using specialized knowledge, skill and experience in combination with careful planning and attention to detail, a bridge can be made with excellent fit, appearance and function and usually be made to last for many years.

All Tooth Replacements

All tooth replacement treatments, in our office, should achieve the following:

  • Restore a smile and chewing ability by eliminating gaps caused by missing teeth
  • Prevent teeth in the area of a missing tooth from tipping over or becoming crooked
  • Help maintain the natural shape of your face by providing support for your lips and
    cheeks
  • …After consultation with Dr. Neale, I decided to proceed with the extensive dental work in my mouth. It was a challenging experience… The end result was worth the effort. Not only is the cosmetic effect great, more than that, the comfort in my mouth is such that I forget I have crowns, bridges and veneers. Thanks Dr. Neale.
    A satisfied customer,Mrs. S.B. Slave Lake
  • I have been a patient of Dr. David Neale over a period of 6 years. Recently he carried out extensive, delicate and complicated restoration work on my teeth, to my complete satisfaction. I shall always be thankful to Dr. Neale and I would certainly recommend him with absolute confidence to anyone.
    Mrs. B.L. Edmonton
  • I am impressed with the professional dental care I received from Dr. Neale and his staff. They were most accommodating and informative. Dr. Neale made me feel very comfortable, and he is someone I trust. His expertise and good judgment gave me a new confident smile.
    Mr. P. G. NWT
  • You have given my girl the joy of smiling. You and your team are the Greatest!
    Sincerely grateful, Mrs. K.C. NWT
  • I have had problems with my teeth since I was 18 years old. … 3 bridges had to be made for me. … I always had trouble with them. [Then treatment started with Dr. Neale] … I am amazed from the work of Dr. Neale ... I have never [had] a bridge done like here! It fits me like it is my tooth. It was absolutely painless and looks great. I can smile again! … Thank you Dr. Neale!
    Mrs. S. B. Fort McMurray
  • I am very happy with my new bridge. Thanks once again for your time, patience and expertise. I look forward to having the maxillary bridge completed in the next few months.
    Mrs. C. C. Fort Vermilion

Case Studies

Bridges

Case Study Title

Mrs. F.B. was referred to our office by her general dentist at age 59 because she had lost two teeth in the upper right area and she was having a tough time chewing. She had worn a removable partial denture but it no longer fit very well. It was apparent to us that the problems were much more extensive than just a couple of missing teeth. Additional teeth were missing, the teeth did not line up or bite very well which accounted for a great deal of the difficulty chewing as well as a very significant compromise in her appearance. There was also periodontal (gum) disease and loose teeth. Mrs. F.B. also had diabetes. Following a period of analysis and consultations, Mrs. F.B. decided to proceed with the removal of the very poor upper teeth, an immediate upper denture, orthodontic braces to align the lower teeth and a bridge to replace a missing tooth in the lower left. The improvement in appearance was very dramatic but her ability to chew was also improved.

Case Study Title

Mr. J.L. came to our office at the age of 53 wanting some improvements to his smile and the replacement of some missing teeth. His teeth were sliding slowly out of their normal position and tipping over because some teeth had been lost and not been previously replaced. Initially, Mr. J.L. was very nervous and anxious about having any dental work done. The first step he wanted to start on was some bleaching (color lightening) of his upper teeth, followed by careful reshaping of some front teeth to make them appear a little straighter. With this turning out to his satisfaction and his gaining confidence, we then proceeded to remove some teeth that had periodontal (gum and bone) disease and were in an uncorrectable position. Some teeth on the lower left had tipped over and they were realigned by slowly moving them back to the proper position. Following this, new crowns were placed on the lower front teeth to better match the color of the upper teeth and a new bridge was placed on the lower left to replace the missing tooth and create an aligned bite. Mr. J.L. was becoming very enthusiastic about the improvements he was seeing and appointments were no longer a cause of stress and anxiety for him. He then decided to proceed with crowns on the two upper front teeth which would be longer lasting and have improved appearance over the temporary bonding. Three back teeth also had crowns placed on them to create an even bite. The last step was to replace a missing molar in the lower right area which required two implants for adequate support. Mr. J.L. now has the smile he wants and his teeth are much more likely to last his lifetime because the important missing teeth have been replaced and his bite is even and stable.

Case Study Title

Ms. K.W. was referred to us by her general dentist when she was 48 years old. She wanted to improve the appearance of her teeth. She also wore a removable partial upper denture but wanted something that was fixed and not removable. The clasp display of the denture bothered her esthetically, there were shadows near the missing front teeth and she wanted lighter colored teeth. She reported that many teeth had been removed many years ago. Following examination, we discussed the various ways of improving the upper front teeth with crowns and bridges to accomplish some of her goals. The missing upper back teeth could be replaced best with implant supported crowns as this would be strongest but, if not all of the teeth had to be replaced from Ms. K.W.’s perspective, then a cantilever bridge would be possible to replace some of the teeth. Because the cantilever bridge involved a smaller financial cost and this was of some concern, Ms. K.W. decided to proceed with this treatment. She decided to simply maintain the lower teeth basically ‘as is’ for the time being. Some gum work was initially required on the upper teeth followed by an extensive bridge with cantilevers, which has been very successful achieving the aesthetic goals and which Ms. K.W. feels is far better than her previous partial denture.